Method of using prourokinase in facilitated percutaneous coronary intervention in patients with acute myocardial infarction

Abstract

In the field of biological medicines, a use of prourokinase (proUK) and variants thereof in facilitated percutaneous coronary intervention (PCI) in patients with acute myocardial infarction is provided. The use includes: within 6 hrs after a patient is afflicted with accurate myocardial infarction (AMI), firstly, performing thrombolytic therapy with proUK or variants thereof, and then, performing a PCI operation, to dredge the infarction related artery (IRA) as soon as possible, and re-establish an effective forward blood flow, such that an ischemic myocardium is reperfused. According to the present invention, the facilitated PCI for treatment of AMI with the proUK or variants thereof has an effect superior to that of direct PCI.

Description

CROSS REFERENCE TO RELATED PATENT APPLICATION[0001]The present application is the US national stage of PCT / CN2008 / 070653 filed on Apr. 1, 2008, which claims the priority of the Chinese patent application No. 200810020100.5 filed on Mar. 31, 2008, which application is incorporated herein by reference.BACKGROUND OF THE INVENTION[0002]1. Field of Invention[0003]The present invention relates to the field of biological medicines, and more particularly to a use of a plasminogen activator prourokinase (proUK) and variants thereof in facilitated percutaneous coronary intervention (PCI) in patients with accurate myocardial infarction (AMI).[0004]2. Related Art[0005]It is a most important strategy, in early-stage treatment of AMI, to dredge the infarction related artery (IRA) as soon as possible to re-establish an effective forward blood flow, such that an ischemic myocardium is reperfused.[0006]Direct PCI and intravenous thrombolytic therapy are two main methods for dredging the IRA and perf...

AI Technical Summary

Benefits of technology

[0025]The reason for the good effect of the combination of proUK or variants thereof and PCI lies in that, proUK or variants thereof are serine proteolysis zymogens having dual characteristics of enzyme and zymogen. After entering the blood circulation intravenously, as a zymogen, proUK or variants thereof will not cause systematic plasminogen activation; and as an enzyme, proUK or variants thereof can dissolve the embolized thrombus with a high selectivity, without acting on hemostatic thrombus at wounds at tissues and organics, and thus prevent hemorrhagic complications upon thrombolytic therapy to the utmost extent. As proUK or variants thereof also have the function of inhibiting platelet aggregation, the incidence rate of reinfarction after thrombolysis may be reduced. The reinfarction rate of AMI treated with proUK or variants thereof is much lower than that of tPA, such that the opportunity of reinfarction after implanting the stent during the PCI operation is reduced, and thus the mortality is significantly reduced.

Problems solved by technology

However, due to the limitations such as the PCI equipment in the local medical institution where the patient visits, whether a skilled operator can be in position timely, and inevitable time delay during the transportation of a patient, even in American with very advanced medical services, only 4% of the patients after referral can achieve the treatment objective of receiving direct PCI for reperfusion within 90 min after the medical visit, and about 60-70% of the patients cannot receive direct PCI therapy in time[4].

However, the effectiveness and safety of the facilitated PCI by using presently approved thrombolytic drugs, such as streptokinase and TPA (including, for example, TNK, reteplase, and alteplase) are significantly poorer than those of the direct PCI[8,9], which may be related to that the TPA thrombolytic drugs may activate the coagulation system upon use and thus the incidence rate of reinfarction is high.

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